ASMS

Working for better health care in New Zealand

The Association of Salaried Medical Specialists (ASMS) is the professional association and union uniting doctors and dentists in New Zealand.

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Burnout rife among senior doctors and dentists working in public hospitals

12 August 2016 The Association of Salaried Medical Specialists

Half of all public hospital specialists surveyed about burnout appear to have very high levels of burnout, says the Association of Salaried Medical Specialists (ASMS).

The ASMS has today published a report on burnout among senior doctors and dentists employed by the country’s 20 district health boards.  The report is called “Tired, worn-out and uncertain”: Burnout in the New Zealand public hospital senior medical workforce, and is available from the ASMS website at https://www.asms.org.nz/wp-content/uploads/2016/08/Tired-worn-out-and-uncertain-burnout-report_166328.pdf.

ASMS represents more than 90% of senior doctors and dentists working in New Zealand’s public hospitals.  It surveyed members using an internationally recognised tool called the Copenhagen Burnout Inventory (CBI), which defines burnout as a state of emotional, physical and mental exhaustion caused by excessive and prolonged stress.

ASMS Executive Director Ian Powell described the results as extraordinary and he called on hospital chief executives to act swiftly to improve the situation.

The survey found:

  • Half (50.1%) of hospital specialists reported symptoms of burnout – ie, high levels of fatigue and exhaustion.
  • Nearly half (42.1%) said this was due to their work, and they cited frustrations with management, intense and unrelenting workloads, under-staffing, and onerous on-call duties.
  • 7% attributed their burnout to their interactions with patients.
  • Three out of five female specialists (59.4%) were likely to be experiencing burnout, compared with 43.9% of male specialists.
  • Burnout was even more prevalent among female doctors aged between 30 and 39, with 7 out of 10 (70.5%) experiencing burnout.  More than half (51.1%) attributed this to their work.
  • The prevalence of burnout in New Zealand’s senior medical workforce is higher than that found in comparable international studies of health sector workers.
  • Some medical specialties reported higher levels of burnout than others – in particular, emergency medicine, dentistry and psychiatry.

Comments provided by specialists as part of the survey included the following:

  • “The inefficiencies and bureaucratic Kafkaesque nightmare slowly erodes your will to live.”
  • “The pressures seem to increase year on year… I see less and less pleasure in medicine for both me and my colleagues.  We have lost the enthusiasm that was always of being a doctor and being a team.”
  • “There is so much work that needs to be done but has to be done out of hours just to keep up.  This is completely unrecognised.”
  • “It’s the constant pressure for numbers, the feeling of failing because with a limited resource we are not able to meet targets.”
  • “For me, the hardest part of being a female in the medical workforce is resisting the notion that we should work in our own time to keep up with our paperwork.”

“These results should concern the people running our public hospitals as much as they concern us,” says Ian Powell.

“It’s not acceptable to have such a critical group of health professionals experiencing these levels of burnout.  This survey tells us that burnout is rife among New Zealand’s senior medical workforce.  We have an excellent public health system in this country but it’s not right to maintain it at the expense of the wellbeing of senior doctors and other health professionals.”

International research indicates that burnout can have serious consequences for patient care, medical errors, rates of staff turnover, and the personal health and job satisfaction of doctors.

“These effects of burnout also cost public hospitals millions of dollars.  Burnout is the result of leadership neglecting our health system and is a significant cause of financial wastage.”

To ASMS’ knowledge, this is the first study in the world to investigate levels of burnout using the CBI in a cross-vocational nationwide survey of senior doctors and dentists.  Mr Powell says this research builds on an earlier study by the ASMS into ‘presenteeism’ by senior doctors and dentists, which found they were routinely going to work when they were ill, often out of a strong sense of duty to their patients and colleagues.

Mr Powell says the ASMS has written to DHB chief executives this week to alert them to the burnout survey results and also remind them of their obligations under the Health and Safety at Work Act 2015. ASMS has asked to meet them as soon as possible to discuss the findings and look for solutions.